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Hourglass deformity after botulinum toxin type A injection
Bahman Guyuron1, Kevin Rose, Jennifer S Kriegler
1Case Western Reserve University, Cleveland, Ohio, USA.
Headache
|March 12, 2004
Summary
Botulinum toxin type A injections into the temporalis muscle can cause a temporary "hourglass" deformity due to muscle atrophy. This previously unreported complication is transient and may be less noticeable in patients with higher body weight.
Area of Science:
- Neurology
- Cosmetic Dermatology
Background:
- Botulinum toxin type A injections are associated with complications like eyelid ptosis.
- Temporalis muscle atrophy leading to an "hourglass" deformity has not been previously documented.
Purpose of the Study:
- To report a novel, transient muscle deformity of the temporalis muscle following botulinum toxin type A injection.
- To describe the characteristics and incidence of this deformity.
Main Methods:
- Prospective observation of patients receiving 25 units of botulinum toxin type A into the temporalis muscle for migraine treatment.
- Collection of pre- and post-injection photographs and patient-reported outcomes via questionnaires.
Main Results:
- A temporary "hourglass" deformity of the temporalis muscle was observed in all 92 patients.
- Symptomatic depression was reported by 26 patients; objective deformity was universal.
- Patients with greater soft tissue coverage (higher body weight) exhibited less pronounced deformities.
Conclusions:
- A new complication, transient temporalis muscle "hourglass" deformity, is identified following botulinum toxin type A injections.
- Patient education regarding this temporary side effect can alleviate concerns.